Frequently Asked Questions about V.A.C.® Therapy
Note: The information on this site is intended primarily for healthcare professionals. Patients should consult with their healthcare professional or healthcare provider regarding their specific medical conditions and treatments as well as the information provided on this site.
V.A.C. Therapy is a unique wound management system specifically designed for many types of wounds through the application of Negative Pressure Wound Therapy (NPWT). Because it is a highly specialized, highly advanced wound management system, caregivers may not be fully aware of many aspects of V.A.C. Therapy. This can include functionality, clinical effectiveness, reimbursement or other aspects.
To assist healthcare professionals, KCI has compiled the following Frequently Asked Questions. For further information, call 00971-4 2045420 or send an e-mail to postmasterME@kci-medical.com and refer to the clinical guidelines and instructions for use provided with the device and dressings.
- What’s the difference between V.A.C. Therapy and other NPWT devices?
- What’s the difference between V.A.C. Therapy and wound drainage?
- How do I know if V.A.C. Therapy is appropriate for my patient’s wound?
- V.A.C. Therapy is more expensive than other treatment options – why should I use it?
- Gauze or foam dressings. Is there a difference?
- What’s the difference between the black foam and the white foam?
- Is the V.A.C. Dressing change a clean or sterile technique?
- Can you treat more than one wound with one therapy unit at the same time?
There is an important difference between V.A.C. Therapy and other Negative Pressure Wound Therapy devices. V.A.C. Therapy has been proven to impact your wound healing outcomes20,5,1,3. Only the integrated V.A.C. Therapy System uses V.A.C. GranuFoam™ Dressings in the wound–other NPWT devices typically use gauze dressings.
Under negative pressure, the hydrophobic, reticulated, open pore structure of V.A.C. GranuFoam Dressings creates an environment that promotes faster20 and more effective5 wound healing at the cellular level compared to gauze11,14. When negative pressure is applied to the wound bed through the V.A.C. GranuFoam Dressing, mechanical forces stretch cells as tissue is pulled into the open pores of the dressing. The stretching stimulates cellular proliferation, which results in the formation of granulation tissue2,12,13.
Because gauze does not have the open pore structures found in the V.A.C. GranuFoam Dressings, gauze has not been shown in bench testing to increase cellular activity, and because of its absorptive nature, gauze may actually interfere with negative pressure delivery and the wound healing process[5,6].
You can learn more about how only V.A.C. Therapy works on the cellular level to promote wound healing.
Draining fluids from a wound can be an important part of healing. However, it is just one of several mechanisms of V.A.C. Therapy. V.A.C. Therapy NPWT is indicated to deliver all of the following mechanisms critical to fast20 and effective5 wound healing:
- Creates an environment that promotes wound healing8
- Promotes granulation tissue formation and perfusion2,12,13,19
- Prepares wound bed for closure9
- Reduces edema10
- Draws wound edges together9
- Removes infectious materials6 and exudates12
V.A.C. Therapy is indicated for a wide range of acute and chronic wounds and is appropriate for use in all care settings. Learn more about V.A.C. Therapy wound types and indications, along with important contraindications and safety information or contact your local KCI representative.
While V.A.C. Therapy may initially seem more expensive, the clinical benefits may actually help facilities lower their overall cost of care. You can learn moreabout V.A.C. Therapy’s demonstrated cost effectiveness.
Yes, there is a clinical difference. Although the V.A.C. GranuFoam Dressing (black foam) may seem like simple surgical foam, it has been specifically engineered to deliver NPWT. There are major differences; 1) the beneficial effects of foam (with open pores manufactured under specifications to achieve a 400-600 micron pore size) on a cellular level that promotes fast20 and effective5 wound healing, 2) the hydrophobic, open pore structure of V.A.C. GranuFoam Dressings adapt to the contours of deep or irregularly shaped wounds in order to provide equal distribution of pressure at the wound site.
For these reasons, gauze will not provide the proven benefits of NPWT by the V.A.C. GranuFoam Dressings, and, in some cases with gauze the pooling of fluids may occur and interfere with the wound healing process11,14.
The black foam – V.A.C. GranuFoam Dressing – is hydrophobic or water repelling. The reticulated, open pore foam allows exudate to be removed and enables the dressing to conform to the wound bed providing the foam-tissue interface. This design allows for increased distribution of negative pressure across the wound bed and stimulates tissue formation granulation.
The white foam – V.A.C. WhiteFoam Dressing – is hydrophilic or moisture retaining. Its higher tensile strength and less adherent properties are typically indicated for use in tunnels and shallow undermining. It is also beneficial for use on exposed hardware and protected exposed tendons and bones.
The decision to use clean versus sterile/aseptic technique is dependent upon wound pathophysiology, physician/clinician preference, and institutional protocol. Dressing applications regarding clean or sterile technique are completely at the preference of the physician/clinician. Disposable components of the integrated V.A.C. (Vacuum Assisted Closure Therapy System, including the foam dressing (i.e., V.A.C. GranuFoam, V.A.C. GranuFoam Silver™, or V.A.C. WhiteFoam Dressing), tubing and drape are packaged sterile and are latex-free. V.A.C. Therapy Unit canisters are packaged sterile or fluid path sterile and are latex-free.
A clinician has the option of applying the dressings in the Operating Room utilizing a sterile/aseptic technique if needed. The clinician can also use clean technique for placement in the home setting or for pathologies that do not require sterile technique. As with all dressings that are packaged sterile, the options for use would be those in compliance with the protocols and institutional policies regarding wound care.
Yes. KCI has established two methods for connecting wounds to one therapy unit: “Bridging” and “Y-connecting.”
Bridging can be accomplished when you have multiple wounds of similar pathology in close proximity to one another. The V.A.C. drape is placed on the intact skin between wounds, and a strip of foam is placed from one wound bed to the other over the draped skin. As long as all pieces of foam are touching each other, you can place the tubing in a central location and use one pump to distribute pressure throughout all the wounds.
Y-connecting allows you to treat multiple, non-infected wounds that are a larger distance apart by using a connector that can support two separate tubing connections. Negative pressure in either situation is evenly distributed across the wounds, yet controlled by one pump.
Please reference the V.A.C. Therapy Clinical Guidelines for more information.
- Vuerstaek, J.D. et al. State-of-the-art treatment of chronic leg ulcers: A randomized controlled trial comparing vacuum-assisted closure (V.A.C.) with modern wound dressings. J. Vasc. Surg. (2006).
- Blume P.A., Walters J., Payne W., Ayala J., Lantis J., Comparison of Negative Pressure Wound Therapy using Vacuum-assisted Closure with Advanced Moist Wound Therapy in the Treatment of Diabetic Foot Ulcers, Diabetes Care, Vol 31: 631-36; April 2008.
- Augustin M., Zschocke I., Nutzenbewertung der Ambulanten und Stationaeren V.A.C. Therapie aus Patientensicht, MMW-Fortschritte der Medizin Originalien Nr. I/2006 (148. Jg.), S. 25-32.
- Apelqvist J., Armstrong D.G., Lavery L.A., Boulton A.J.M, Resource utilization and economic cost of care based on a randomized trial of vacuum-assisted closure therapy in the treatment of diabetic foot wounds, The American Journal of Surgery, March 2008.
- McNulty et al, Wound Repair and Regen 2007: 15; 838-846
- Moues, J Plast Reconstr Aesthet Surg. 2007;60(6):672-81
- Argenta, A., Webb K., Simpson J., Gordon S., Kortesis B., Wanner M., Kremers L., Morykwas M. Deformation of Superficial and Deep Abdominal Tissues with Application of a Controlled Vacuum. European Tissue Repair Society, Focus group meeting Topical Negative Pressure (TNP) Therapy, 4–6 December 2003, London.
- Morykwas et al. Ann Plast Surg. 1997 Jun;38(6):553-62.
- Morykwas et al. Ann Plast Surg. 2001 Nov;47(5):547-51.
- Timmers et al. Ann Plast Surg. 2005 Dec;55(6):665-71.
- Morykwas et al. Ann Plast Surg. 1997 Jun;38(6):553-62.
- Charles K. Field et al. Overview of Wound Healing in a Moist Environment. American Journal of Surgery, 1994.
- Joseph E., Hamori CA., Bergman S., Roaf E., Swann N., Anastasi G. Prospective Randomized Trial of Vacuum-Assisted Closure versus Standard Therapy of Chronic Non-healing Wounds. Wounds, 2000; 12(3): 60–67.
- Kamolz LP et al., Burns. 2004 May;30(3):253-8.
- Brian Bucalo MD, William H. Eaglestein, MD, Vincent Falanga, MD. Inhibition of Cell Proliferation by Chronic Wound Fluid. Wound Repair and Regeneration, 1993.
- Argenta, L. C., Morykwas, M. J. Vacuum-Assisted Closure: A New Method for Wound Control and Treatment: Animal Studies and Basic Foundation. Annals of Plastic Surgery, 1997; 38(6).